Midline Diastema Research Articles

Stability of Midline Diastema Closure by Frenectomy and Orthodontic Treatment: A Systematic Review

Introduction: Midline diastema is one of the most common aesthetic complaints in mixed and sometimes in permanent dentition stage. High frenal attachment is the major aetiological factor causing midline spacing. Combined frenectomy and orthodontic treatment can be done to close the midline diastema which may also increase the stability and reduce relapse. Aim: To assess the stability of midline diastema closure by using frenectomy and orthodontic treatment. Materials and Methods: A systematic review was conducted about clinical trials showing the stability of midline diastema closure by using frenectomy and orthodontic treatment, articles were searched from 1995 to 2022. A total of 521 articles were retrieved. Among these 433 articles were screened. The risk of bias was assessed for all the studies included in this review. Results: A total of five studies were included in the systematic review which has clinical trials showing the stability of midline diastema closure in patients having midline diastema of at least 0.5 mm. Four studies using orthodontic treatment has shown some amount of relapse and one study using orthodontic treatment and frenectomy has shown prominent closure of median diastema. Conclusion: Closure of maxillary median diastema is more prominent when it is performed by using combined frenectomy and orthodontic treatment than orthodontic treatment alone and the risk of relapse is minimal. However, furthermore clinical studies are required to confirm the stability of midline diastema closure by using orthodontic treatment and frenectomy.

Developmental Defect of Enamel with Midline Diastema: A Case Report, One Year Follow-Up

Developmental Defect of Enamel with Midline Diastema: A Case Report, One Year Follow-Up

Prevalence of Maxillary Labial Frenal Attachments Types and Midline Diastema in Egyptian Children with Fully Erupted Maxillary Permanent Canines: A Cross Sectional Study

Prevalence of Maxillary Labial Frenal Attachments Types and Midline Diastema in Egyptian Children with Fully Erupted Maxillary Permanent Canines: A Cross Sectional Study

Management of midline diastema using pressable ceramics and zirconia crowns: a case series

Maxillary and mandibular midline diastema (MMD) is frequently observed in various populations. The occurrence of MMD can be attributed to multiple factors, including etiological, developmental, and patient habits. The diverse options to treat MMD are orthodontic correction, direct and indirect restorations, crowns, and veneers. This case series presents instances of closing maxillary and mandibular midline diastema using e.max veneers and zirconia crowns.

MULTIDISCIPLINARY APPROACH TO MIDLINE DIASTEMA CAUSED DUE TO HIGH FRENUM ATTACHMENT.

Midline diastema can be defined as a space between the maxillary central incisors. In growing patients midline diastema can be seen as a physiological condition that is self-correct after the eruption of all permanent teeth. This phenomenon of self-correct condition was explained by Broadbent. But not all diastemas are self-correcting. For some patients, the diastema does not close at all. There are various reasons for the occurrence of upper arch midline diastema that must be considered, with the help of intraoral evaluation, including soft tissue/ mucosal diseases, tooth size discrepancies, teeth angulation among others. The case presented described presence of midline diastema due to high frenal attachment in a female aged 17 years. A multidisciplinary approach was taken for this case involving orthodontic and periodontal treatments. Periodontology involvement was for frenectomy.

Should midline diastema in mixed dentition be an aesthetic concern?

Mixed dentition determines an important period of occlusion development in childhood. This study aimed to evaluate the aesthetic impact of the midline diastema cut-off point in mixed dentition. A cross-sectional study was performed with 257 children aged 8-10 years in late mixed dentition, with midline diastema of 1-5 mm and normal maxillary overjet. Orthodontic Aesthetic Subjective Impact Score determined the aesthetic impact of the midline diastema. Four quartiles of diastema measurements and impact scores were considered as cut-off points. Receiver Operating Characteristic curves were constructed, and the distances representing the distances to the ideal point were calculated. The Yuden index determined the efficiency of measuring the diastema to assess the aesthetic impact. The Kruskal-Wallis test compared the groups of participants classified according to the diastema cut-off by the sample quartile regarding the impact score. The analyses were performed with a significance level of 5%. There was no significant difference between the four groups of measurement quartiles of the diastema regarding the aesthetic impact (P > .05). The perception of dental aesthetics in mixed dentition children was not affected by the midline diastema, regardless of the cut-off point.

Midline Diastema Closure Using an M Spring in a Young Adult: A Case Report

The malocclusion known as maxillary midline diastema frequently occurs. For the management of diastema, a variety of therapy approaches are recommended. This article gives a case report of a female patient, age 24, who underwent treatment for a 4-mm maxillary midline diastema following the extraction of an additional tooth between her upper central incisors. The orthodontic treatment index was minimal (grade 2). The maxillary central incisors were fitted with bonded McLaughlin-Bennett-Trevisi (MBT) 0.018" brackets. A rectangular archwire was used after the circular archwire to ligate and activate the M spring. The diastema was successfully closed after a total of four months of treatment. This approach is effective and efficient and uses minimal inventory. This shortens the length of the orthodontic treatment and conserves valuable chairside time.

Impact of Dental Aesthetic Index characteristics on the severity levels of malocclusion in a non-White population

This study evaluated the impact of the esthetic and occlusal characteristics of the Dental Aesthetic Index (DAI) on the need for orthodontic treatment in a non-White population. A cross-sectional study was conducted with 1296 non-White adolescents aged 12 years. DAI was the outcome variable (DAI 1 and 2 and DAI 3 and 4). The independent variables were categorized on the basis of the occlusal esthetic characteristics evaluated by DAI (tooth absence, crowding, spacing, midline diastema, maxillary misalignment, mandibular misalignment, maxillary anterior overjet, mandibular overjet, anterior open bite, and anteroposterior molar relationship). Simple logistic regression models were adjusted for the outcome, and the raw odds ratios were estimated. Variables with a P value of<0.20 for individual analyses were tested in a multiple logistic regression model, with P≤0.05 remaining. A total of 1296 adolescents (764 girls and 532 boys) were evaluated; 1067 (82.3%) had DAI 1 or 2 (minor to a moderate need for orthodontic treatment), and 229 (17.7%) had DAI 3 or 4 (defined need for orthodontic treatment). The results showed that adolescents with diastema, maxillary irregularity, mandibular irregularity, mandibular overjet, anterior open bite, and the altered molar relationship had 5.34, 2.36, 2.63, 3.56, 8.73, and 5.16 times more likelihood to have DAI 3 or 4 (P≤0.05), respectively. Diastema, maxillary and mandibular misalignment, mandibular overjet, anterior open bite, and anteroposterior molar relationship were the characteristics that influenced the determination of the need for orthodontic treatment in a non-White population using the DAI index.

Clinical Management and Micro-Computed Tomography Analysis of Supernumerary Teeth in Infancy: A Case Report

Supernumerary teeth develop from excessive proliferation and development of the dental lamina. Supernumerary teeth can cause several problems, including ectopic eruption, delayed eruption, root resorption of adjacent teeth, and diastema. Supernumerary teeth in infancy are rare and have rarely been reported. Case of a 2-day-old infant with 3 supernumerary teeth is presented here and the patient was followed up for 21 months. The erupted supernumerary tooth in the primary dentition was extracted under moderate sedation at the age of 14 months. Microcomputed tomography analysis of the extracted tooth confirmed microscopic root malformation. After extraction, the midline diastema was reduced and oral hygiene improved. Early diagnosis and prompt treatment can prevent complications of supernumerary teeth.

Midline diastema: A brief overview of its aetiology and management

Midline diastema: A brief overview of its aetiology and management

Challenge of Aesthetic Rehabilitation in Case of Fractured Anterior Teeth with Diastema and Gummy Smile

The success of a restorative treatment in anterior teeth for a patient who lost dental aesthetic depends on the esthetic integration between soft tissues and hard tissues with less invasive procedure. (1/2) The present available case report describes the esthetic management of gummy smile, fractured incisor teeth and midline diastema with a multidisciplinary approach of different specialties from diagnosis to treatment planning.Ceramic veneers and crowns yielded a good aesthetic and functional outcome.

Enhancing the esthetics of face by management of midline diastema: A Case Report

Maxillary midline diastema is a common esthetic problem in mixed and permanent dentition. The space can occur either as a transient malocclusion or created by developmental, pathological or iatrogenic factors. Along with midline diastema, anteriors can have generalised spacing, particularly in the maxillary arch. These can be managed by surgical, orthodontic, restorative and prosthodontic procedures, or by a combination of procedures to meet the patient’s aesthetic and functional needs while also improving the patient’s psycholog

Management of maxillary midline diastema caused by aberrant frenum attachment: A case report

Background: Midline diastema in the maxillary is very common aesthetics problem in mixed and early permanent dentition, one of which etiology is aberrant frenum attachment. High frenum attachment might interfere with aesthetics, plaque control, and create mucogingival deformities, therefore compromising orthodontic result and causing recurrence. Several treatments for maxillary midline diastema are available, one of which is labial frenectomy. Objective: To present a case report of frenectomy as a mean of eliminating maxillary midline diastema. Case: This is a case report of a 25 years old female patient with high frenum attachment causing maxillary midline diastema. Patient was treated with frenectomy afterward. Frenectomy is a complete removal of frenum, including the attachment to the underlying bone. Following the treatment, midline diastema closure was showed in 4 months following frenectomy. Conclusions: Frenectomy is a potential alternative for treatment of maxillary midline diastema.

FRENECTOMY - DIFFERENT TECHNIQUES

Introduction:-The frenum is a mucous membrane fold that attaches the lip , cheek and the tongue to the alveolar mucosa, the gingiva, and the underlying periosteum .Aesthetic problems are caused by high maxillary frenum which may compromise the orthodontic treatment results in the midline diastema cases, thus causing a recurrence after the treatment. Ankyloglossia, is also called as tongue-tie, is an embryological anatomical malformation of the tongue, characterized by an abnormally short and a thick lingual frenum. Tongue-tie restricts the physiologic movements of the tongue and results in various functional, behavioural and speech abnormalities. Material method :- The present article consists of a series of clinical cases of an aberrant frenum which were approached by various surgical frenectomy techniques. Result:- Different techniques have their own advantages and disadvantages. Laser gives advantages of less post operative pain and discomfort. Lingual frenectomy help in improvement in tongue movement and speech. Conclusion:- An aberrant frenum can be removed by any of the modification techniques that have been proposed,and a functional and an aesthetic outcome can be achieved by a proper selection of technique which is based on the type of the frenal attachment.

Management of maxillary midline diastema caused by aberrant frenum attachment: A case report

Management of maxillary midline diastema caused by aberrant frenum attachment: A case report

Partial Laminate Veneers for a Maxillary Midline Diastema Closure: A Case Report

Background: A variety of approaches can be employed to close diastemas using conservative and non-conservative restorative techniques such as composite restorations, laminate veneers, and crowning if there is no indication for orthodontic treatment. Objectives: This paper aimed to discuss the mechanical properties of sectional laminate veneers, the preparation, and the ceramic material used for their manufacturing. Material and methods: A case of a maxillary midline diastema closure using feldspathic partial laminate veneers with an ultra-conservative preparation is described. Results: Feldspathic sectional laminate veneers achieve an esthetically pleasant diastema closure. The ultra-conservative preparation and adequate polishing technique preserve dental and gingival tissues. Conclusion: It can be concluded that sectional partial veneers are an esthetic option with low mechanical properties that must be carefully indicated.

Maxillary labial frenum and malocclusion: An overriding or an overlooked tissue?

The influence of the maxillary labial frenum in relation to the midline diastema has been a proven fact to clinicians for many years. A pilot study was carried out to investigate the relationship between a low maxillary labial frenum attachment and skeletal malocclusions (class I, II, and III). Astonishingly, it was observed that the class III malocclusion had a statistically high number of cases with low frenum attachments. The objective of the study was to understand the underlying skeletal class III dysplasia in these cases. A comparative cross-sectional study was performed on 300 consecutive subjects between 13-30-years of age. Based on the cephalometric parameters the participants were categorized into 98 skeletal class I, 102 class II, and 100 class III subjects. Variations in the frenum attachment were clinically evaluated using Placek classification. The insertion level and width of the frenum were also measured by using a caliper and the data were statistically analyzed for determining the association between the frenum attachment and skeletal malocclusion. The prevalence of low frenum attachment in class III subjects was found to be 64%. Also, the mean attachment level of the frenum was significantly closer to the gingival margin in skeletal class III subjects compared with that of the other groups (p&amp;#60;0.01). The study identified that the subjects with a low frenum attachment had a tendency towards a retruded maxilla in terms of linear dimension. Therefore the present study supports the hypotheses that the skeletal Class III malocclusion may be associated with low frenum attachment.

Frequency of Midline Diastema in patients reported To OPD of Bacha Khan Medical College Mardan

Background: A space between adjacent central incisor teeth is termed "diastema or diastemata". Midline diastema in mixed dentition is a great center of concern for parents as well as their children, therefore, determining the time of closure of midline diastema is essential for clinical practice in Orthodontic and the study was aimed to determine the frequency of midline diastema in both maxillary and mandibular arches in patients. Material and Method: The current study was carried out at Bacha Khan Medical College Mardan, Khyber Pukhtoon Khwa to determine the frequency of midline diastema in both maxillary and mandibular arches in patients for which a total of 200 responders have examined 100 responders were males while 100 were female. Results: The frequency of Midline diastema was 12%, out of 200 hundred in which Maxillary midline diastema was 5% and Mandibular midline diastema was 5.5% and both the arches were found to be 1.5% in females. Conclusion: The finding of the current study is that the population of Khyber Pukhtunkhwa has several Midline diastemata affecting their esthetic. A similar study to find out the etiology of Midline diastema is suggested which requires a large sample size. Keywords: Midline diastema, Frequency, Orthodontic

Eye movement analysis of children's attention for midline diastema.

No previous studies have investigated eye-movement patterns to show children’s information processing while viewing clinical images. Therefore, this study aimed to explore children and their educators’ perception of a midline diastema by applying eye-movement analysis using the hidden Markov models (EMHMM). A total of 155 children between 2.5 and 5.5 years of age and their educators (n = 34) viewed pictures with and without a midline diastema while Tobii Pro Nano eye-tracker followed their eye movements. Fixation data were analysed using data-driven, and fixed regions of interest (ROIs) approaches with EMHMM. Two different eye-movement patterns were identified: explorative pattern (76%), where the children’s ROIs were predominantly around the nose and mouth, and focused pattern (26%), where children’s ROIs were precise, locating on the teeth with and without a diastema, and fixations transited among the ROIs with similar frequencies. Females had a significantly higher eye-movement preference for without diastema image than males. Comparisons between the different age groups showed a statistically significant difference for overall entropies. The 3.6–4.5y age groups exhibited higher entropies, indicating lower eye-movement consistency. In addition, children and their educators exhibited two specific eye-movement patterns. Children in the explorative pattern saw the midline diastema more often while their educators focussed on the image without diastema. Thus, EMHMMs are valuable in analysing eye-movement patterns in children and adults.

Relationship between Maxillary Midline Diastema Width and Labial Frenum Attachment in a Sample of Nigerian Adolescents

Background: The maxillary midline diastema is a space between both upper central incisors which is more than 0.5 mm in width, and there are varying factors attributed to its occurrence. Aim: The purpose of this study was to determine the relationship between maxillary midline diastema width and labial frenum attachment among secondary school students in a Nigerian rural community. The study also assessed the prevalence of maxillary midline diastema and the distribution of labial frenal morphology. Materials and Methods: A cross-sectional study was conducted among 200 adolescents in Southwestern Nigeria. Participants were selected using a three-stage stratified sampling technique, and structured questionnaires were employed. Intraoral examination was done to assess the presence of maxillary midline diastema, classify the morphology of the upper labial frenum and measure the width of the maxillary midline diastema. Results: The participants were aged between 10 and 17 years (mean age, 12.69 ± 2.1 standard deviation). The prevalence of maxillary midline diastema was 31.5% among participants with gingival attachment being the most prevalent frenal morphology. Participants with papillary frenal attachments had statistically significant wider maxillary midline diastema than those with gingival frenal attachments (P &lt; 0.05). Conclusions: Among Nigerian adolescents, there was an association between the type of labial frenal attachment and width of maxillary midline diastema.